A senior member of the
Royal College of General Practitioners told MPs yesterday that health scares
over osteoporosis and high blood pressure were created largely by pharmaceutical
companies intent on selling their drugs.

Dr Iona Heath, the outgoing chairman of the college's
committee on medical ethics, said people's bones became thinner naturally
as they became older, but there was no correlation between bone density
and fracture rates.

"It is a continuum," she said. "I would
not dispute that at the end of the continuum there are people whose bones
cause problems. But there is no cut-off point where someone has good bones
and someone has bad bones."

She suggested women over 50 should stamp on the floor
instead of taking drugs to prevent their bones thinning.

Dr Heath told the Commons health select committee
that pharmaceutical companies were "disease-mongering" and creating
"disease creep" where more and more people were told that there
was something wrong with them.

In the case of osteoporosis, she said that when older
women had their bone density measured it was compared with the bone density
of a young woman, even though this was bound to show up a problem. "The
same thing is happening with high blood pressure," she said. "We
are only just beginning to understand the health effects of making people
worried about their health.

"It's a huge problem for the future. People feel
that their body is somehow sabotaging them. If someone is told that they
have high blood pressure, they think about it, on average, seven times a
day. This introspective health surveillance is the absolute antithesis of
health."

Dr Heath, who received the CBE in 2000 for her work
in the medical profession, was one of the latest batch of witnesses to appear
before the committee's inquiry into the influence of the pharmaceutical
industry on the health service.

She was responding to a question from David Hinchcliffe,
who heads the committee, about so-called "disease awareness campaigns",
which are the only way in which pharmaceutical companies are allowed to
promote their products.

Because the companies are not allowed to promote their
own drug for a particular condition, they may attempt to raise patient awareness
of that condition through advertising, which may lead to more prescriptions
being written for the company's drugs.

Dr Heath said: "We GPs regard part of our role
as defending patients against the pharmaceutical industry".

She said that, because of the industry's campaigns,
she was seeing large numbers of patients who were "inappropriately
worried" about their health, and that this had "huge personal
and social implications for them, and huge financial implications for society".

She also cited the large numbers of rich patients
who are unnecessarily worried about their cholesterol level, saying that
plans to make some cholesterol-lowering statins available over the counter
without prescription would only exacerbate the problem. "The fittest,
wellest people spend the most time worrying about cholesterol," she
said, adding that people with poorer diets who might benefit from the drugs
did not have time to worry about their cholesterol levels.

Osteoporosis is a very common condition, strongly
linked to ageing and affecting one woman in three and one man in 12 over
the age of 50.

It is a natural condition in which bones lose density
and fracture more easily. Bone density reaches its peak when men and women
are in their thirties and declines after that. But not everyone who has
osteoporosis will sustain a fracture.

An estimated 70,000 hip fractures, 50,000 wrist fractures
and 120,000 spine fractures are caused by the condition each year.

In women, osteoporosis is associated with the drop
in levels of the hormone oestrogen after the menopause. Men with osteoporosis
are sometimes treated with the male hormone testosterone.

Dr Heath's argument that there is no correlation between
bone density and the rate of fractures in osteoporosis opposes accepted
medical thinking. A spokesman for the National Osteoporosis Society said
yesterday: "For every 10 per cent drop in bone density below average,
the risk of fracture doubles.

"This risk increases as people get older, because
the risk of falling is greater," she said.

With a very large potential market the drugs industry
has been active in recent years in producing drugs for osteoporosis. They
include bisphosphonates, non-hormonal drugs that help to maintain bone density
and Serms.

Serms, selective estrogen receptor modulators, act
in a similar way to oestrogen in bone, again helping to maintain density.

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